Smoking cessation + vaping; transcript and analytics

Weds Feb 8th, 10pm UK/Ire, 5pm ET

https://storify.com/drlfarrell/irishmed-smoking-cessation-and-vaping

http://www.symplur.com/healthcare-hashtags/irishmed/analytics/?hashtag=irishmed&fdate=02%2F08%2F2017&shour=14&smin=00&tdate=02%2F09%2F2017&thour=00&tmin=00

https://nodexlgraphgallery.org/Pages/Graph.aspx?graphID=94344

Interview with Gilliane Golden https://firetalk.com/events/rkCczEtOg

http://www.vidoyen.com/questions/this-week-s-irishmed-smoking-cessation-and-vaping/answers/liam-farrell

Co-host @GillianeGolden

Gillian Golden, ex smoker of four and a half years thanks to switching to an e-cigarette, and who now works for the Irish Vape Vendors Association, Ireland’s only trade association for the Irish vaping industry which has no ties to tobacco or pharmaceutical companies. The IVVA advocates for evidenced based policies which keep vaping accessible and affordable to current adult smokers.

Vaping, smoking and harm reduction – where do we go from here?

Vaping (using an e-cigarette) is a form of smoking harm reduction. Harm reduction can be briefly explained as substituting a harmful behaviour (consuming nicotine via smoking combusted tobacco) with a less harmful one (consuming nicotine via an e-cigarette).

England, after 2 landmark reviews by Public Health England and the Royal College of Physicians which found that vaping is at least 95% safer than smoking, is encouraging their use by smokers. Guidance is given to smoking cessation services on how they can be incorporated into the arsenal of aids to help smokers, and to employers and organisations, on how they can develop policies on their use in public places.

https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review

https://www.rcplondon.ac.uk/news/promote-e-cigarettes-widely-substitute-smoking-says-new-rcp-report

http://www.ncsct.co.uk/publication_electronic_cigarette_briefing.php

https://www.gov.uk/government/news/vaping-in-public-places-advice-for-employers-and-organisations

Some NHS trusts are rolling back bans on their use in hospital grounds, cognisant of their aim of supporting smokers who decide to quit, regardless of the method used and the fact that vaping presents no harm to bystanders. Many British public health and health groups have endorsed their use. Research into their safety, use and impact on public health is supported by a wide variety of disciplinary research teams such as pulmonology, epidemiology, smoking in pregnancy, smoking among people with mental health issues, dentistry, oncology and cardiology.

Dedicated vape shops, (owner operated specialist shops by small independent, ie non tobacco company businesses) have been at the forefront of bringing the technological and experiential product advances of e-cigarettes to smokers. However, regulation on the products in the EU is not harmonised, and is severely restrictive in terms of the communication of the relative safety of vaping versus smoking.

In Leicester, the Stop Smoking Service has seen a marked increase in the number of people successfully stopping smoking since their service became “ecig friendly” and Louise Ross, who has been at the forefront of this change explains what the means here:

http://www.clivebates.com/?p=3215

The US, Australia and New Zealand are among the countries that take a more abstinence-only view of the consumption of nicotine and their regulatory approaches are far more strict.

In Australia for example, the sale of nicotine for e-cigarettes remains illegal, while tobacco cigarettes are freely available. Adults are free to import nicotine from abroad for personal use up to a limit per

transaction, however this is costly and not available to smokers who aren’t not internet savvy or those in lower socioeconomic groups, where smoking prevalence is higher.

In the US, extensive lobbying by the pharmaceutical industry funded health organizations, and by tobacco companies, has led to an FDA regulation that will likely wipe out over 99% of the most effective e-cigarette products, and leave the path open for tobacco companies to control the market.

Other countries, India and Malaysia for example, adhere more closely to the World Health Organization’s view which focuses on the negative possible harms from vaping, while ignoring that worldwide, the rate of smoking remains about 20%. They put forward a position that results in poor advice to smokers, and would shape policies that ban vaping in countries where smoking rates are highest. A recent position paper on e-cigarettes by the WHO was criticized by, among others, the UK Centre for Tobacco and Alcohol Studies:

http://ukctas.net/news/commentary-on-WHO-report-on-ENDS&ENNDS.html

Some countries like Ireland and the UK have targets to become “tobacco free”; Ireland has a target of less than a 5% smoking prevalence rate by 2025.

With the WHO estimating that 1 billion people will die from smoking this century, 5,600 of which will die this year in Ireland according to the Irish Department of Health, how do we get across to smokers that if they can’t quit by any other means, switching to an e-cigarette is a better alternative than continuing to smoke?

Are we focussing too much on cessation, without taking into account the pleasure principle, as outlined here by Sarah Jakes, trustee of the UK charity New Nicotine Alliance?

http://nnalliance.org/blog/39-the-pleasure-principle

And with evidence that public misperceptions about the relative safety of e-cigarettes is rising, how do we shape balanced risk communication for smokers?

* T1 Should the wider debate on smoking focus on “smoke free” or “nicotine free”?

* T2 What do you think smokers should know about vaping and e-cigarettes?

* T3 How should media scare stories on vaping be countered?

* T4 What are the barriers to greater uptake of e-cigarettes by smokers?

* T5 How would you shape a public information campaign for smokers on e-cigarettes and vaping?

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